DR. OLLIE JOSEPH JACKSON III M.D.
NPI 1104084698
Surgery in Beverly Hills, CA

Active since May 30, 2008PECOS EnrolledAccepts Medicare Assignment
9001 WILSHIRE BLVD, SUITE #106, BEVERLY HILLS, CA 90211(310) 273-8885(310) 273-8662 Get Directions Write a Review

NPPES record last updated: March 15, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Ollie Joseph Jackson Iii M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. OLLIE JOSEPH JACKSON III M.D. (NPI 1104084698) is an individual surgery provider in Beverly Hills, California, licensed in California (A103543) and active in the NPI registry since May 2008. He is enrolled in Medicare PECOS and is a graduate of University Of Oklahoma College Of Medicine (2001).

NPPES Registry Identity

NPI1104084698
Entity TypeIndividualMale
Primary Taxonomy208600000X
Provider Legal NameDR. OLLIE JOSEPH JACKSON IIICredential: M.D.
Location Address9001 WILSHIRE BLVD, SUITE #106Beverly Hills, CA 90211-1838
Mailing Address9001 Wilshire Blvd, Suite #106Beverly Hills, CA 90211-1838 · (310) 273-8885 · Fax (310) 273-8662
Fax(310) 273-8662
Sole ProprietorYes
Medical School CMSUniversity Of Oklahoma College Of MedicineGraduated 2001
Enumeration DateMay 30, 2008
Last NPPES UpdateMarch 15, 2023
NPPES CertifiedMarch 15, 2023
NPI 1104084698 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtySurgeryAllopathic & Osteopathic Physicians
Taxonomy Code208600000X
License Licensed in CA · A103543
Definition
A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.
Also ListedSurgery · Plastic and Reconstructive SurgeryTaxonomy 2086S0122X · License A103543 (CA)
9001 WILSHIRE BLVD, Beverly Hills, CA 90211

Other Names 1

Other Name (5)Dr. Jay Jackson M.d.

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X MULTIPLE SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Dr. Ollie Joseph Jackson Iii M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID3476707043
PECOS Enrollment IDI20230501002893
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 90211 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$96.36 typical visit price
range $62.96 – $187.60
Typical copayment $24.09 (range $15.74 – $46.90)
Most-billed visit code 99203
Established Patient
$77.96 typical visit price
range $20.84 – $153.61
Typical copayment $19.49 (range $5.21 – $38.40)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Clinic/Center (Multi-Specialty)
9001 WILSHIRE BLVD, SUITE 106
BEVERLY HILLS, CA 90211
Clinic/Center (Ambulatory Surgical)
9001 WILSHIRE BLVD, SUITE 106
BEVERLY HILLS, CA 90211
Surgery
9001 WILSHIRE BLVD, SUITE 304
BEVERLY HILLS, CA 90211
Surgery
9001 WILSHIRE BLVD, SUITE 105
BEVERLY HILLS, CA 90211
Clinic/Center (Multi-Specialty)
9001 WILSHIRE BLVD, SUITE 106
BEVERLY HILLS, CA 90211
Clinic/Center (Multi-Specialty)
9001 WILSHIRE BLVD, SUITE 106
BEVERLY HILLS, CA 90211
Physical Therapist
9001 WILSHIRE BLVD, 102
BEVERLY HILLS, CA 90211
Legal Medicine
9001 WILSHIRE BLVD, 302
BEVERLY HILLS, CA 90211

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Ollie Jackson's NPI number?

The NPI number for Ollie Jackson is 1104084698. It was assigned to this individual provider in the NPPES registry on May 30, 2008. The provider is also known as Dr. Jay Jackson M.D..

Where is Ollie Jackson located?

Ollie Jackson practices at 9001 Wilshire Blvd Suite #106, Beverly Hills, CA 90211. The listed phone number is (310) 273-8885.

What is Ollie Jackson's specialty?

The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.

Is Ollie Jackson enrolled in Medicare?

Yes. Ollie Jackson is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Ollie Jackson was last updated on March 15, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.